Huisartsgeneeskunde: aantrekkingskracht en beroepstrouw ... - Lirias

KCE Reports 90 Making General Practice Attractive: Encouraging GP attraction and Retention 95
6.4.2 Gathering and validation of names
The selection of the stakeholders has been done according to their power to influence
options. This power has been evaluated according to two types of resources i.e.,
tangible and intangible resources 192 :
1. Tangible resources include, with respect to their group, position in the
formal decision hierarchy, size of the budget, number of members, votes,
position.
2. Intangible resources include expertise, legitimacy knowledge and
networking position (access to the media and policy makers).
3. The list was elaborated according to the following steps 196:
4. Researchers working in academic and public health institutions as well as
other sources of information (e.g. professional bodies) proposed a broad
list of 252 names of stakeholders according to the previously proposed
criteria of power.
5. A researcher checked the validity of each proposal through phone calls to
the institutions and knowledgeable people. Those phone calls confirmed
the person’s role and status.
6. Reviewing and completing the list was the focus of several meetings
involving all researchers.
7. They selected a list of 155 names based on :
• The most influential and/or knowledgeable persons within institutions
(after contact with those institutions),
• A balance between different institutions from the same nature.
8. After a new check of the list, 7 leaders from different professional and
public health organizations have ranked the 155 names. The ranking has
been done according to the tangible and intangible resources mentioned
above using an ordinal scale. The possibilities of responses for each
stakeholder were the following: yes (=this person is influential), no, I have
no opinion, I don’t know this person. The rankers also had the possibility
to comment about the names of the list in order to correct the last
mistakes that left. The Fleiss’ extension of kappa has been computed
(“generalized kappa”-formula in appendix 5.6). The Kappa had a value of
0.44 when including all rankers (Table 11: Reliability of the scoring of the
stakeholders: kappa (details in appendix 5.7). That low value confirms that
the rankers came from various backgrounds in order to ensure a wide
knowledge of all potential stakeholders.
Table 11: Reliability of the scoring of the stakeholders: kappa
Type of analysis Kappa F test P value
All raters 0.44 4.76 0.00
FR raters 0.48 1.84 0.00
NL raters 0.57 3.93 0.00
The researchers selected the stakeholders having a score of ≥ 4 (i.e. chosen by at least
four raters over 7) i.e., 45 persons. The distribution of the stakeholders in each group
was balanced as follows:
• policymakers (n=19 i.e. 42%),
• sectional groups (unions) (n=15 i.e. 33%),
• cause groups (universities) (n=10 i.e. 22%),
• media (n=1 i.e. 2%).